2nd ICJR SEA
THEME: CHALLENGES IN ARTHROPLASTY

   
  REGISTRATION  
     
 
FOR GROUP REGISTRATION, PLEASE CLICK HERE   FOR REGISTRATION FORM, PLEASE CLICK HERE
 
     
  Please complete the following registration form. Make sure to include ALL contact information (email address, mailing address, telephone & fax) to ensure receipt of your Registration Confirmation Email. All registration MUST be accompanied with payment. Registration without payments will not be processed.  
     
 
A. PERSONAL DETAILS
Title  
Full Name as per IC / Passport  
Institution / Hospital  
Correspondence Address  
City  
Postcode  
Country  
Mobile Phone   (country code)(area code)(telephone no)
Email  
Profession  
Letter for Visa Application  
Yes No
Dietary Requirement  
Vegetarian Non-Vegetarian
     
* If you are registering for yourself, please go to part C.
     
B. INSTITUTION / COMPANY SPONSOR DETAILS
Company Name  
Contact Person's Name  
Mobile Number  
Office Number  
Email  
* Institution / Company Sponsor details are compulsary if you are a sponsor and would like to be kept updated on registration.
     
C. REGISTRATION FEES
Category Early Bird Promotion
(Before 30th June 2015)
Post Early Bird
(1st July to 31st August 2015)
Onsite Registration
(1st to 14th September 2015)
South East Asia Medical Officer /
Master Trainee
  RM 500 / USD 130
 RM 500 / USD 130
South East Asia Surgeon RM 900 RM 1,200 / USD 350
 RM 1,500 / USD 430
Overseas Surgeon RM1,100 RM 1,400 / USD 410
 RM 1,700 / USD 490
A RM100 (USD 30) discount in registration fee is given to active or life member of:-
Malaysian Orthopaedic Association (MOA)
Asia Pacific Orthopaedic Association (APOA)
A RM200 (USD 60) discount in registration fee will be given if you are:-
both an active or life member of MOA & APOA.
Non Member
TOTAL REGISTRATION FEE RM
  • Above registration fees are subject to the prevailing government service tax (GST) at 6%.
  • Please provide a proof of your payment membership when making your registration online at www.icjrsea.com.
  • South East Asia Countries include Brunei, Cambodia, East Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam.
  • Please provide us your membership letter (you can obtain from your respective association) and attach together with your registration form to be entitled for the discount.
  • If you are a Medical Officer or Master Trainee, please attach a letter from your University Dean or Head of Faculty on University letterhead.
 
D. PAYMENT MODE
Please Select Payment Mode  
Bank-in Cash or Cheque Letter Of Guarantee
Online Transfer or Telegraphic Transfer Local Purchase Order (LPO)
Sponsored By Company PayPal
     
Attach Payment Proof    [ max file size : 20MB ]
Attach Membership Proof    [ max file size : 20MB ]
Attach Letter From University    [ max file size : 20MB ]
 
All payments are to be issued in favour of MD CME ASIA SDN BHD (ICJRSEA)
Bank Name   Malayan Banking Berhad
Bank Address   1 Jalan Maarof, Dataran Maybank, 59000 Kuala Lumpur
Account No   514253522033
Swift Code   MBBEMYKL
Bank Branch Telephone   +603 2283 1017
 
All registered conference attendees will be emailed confirmations. Print your confirmation letter and bring it with you on the day of the conference for a smooth registration process.
 
The secretariat must be notified in writing of all cancellations. Refund will be made only after the conference and only applicable under following circumstances.

Cancellation on or before 1st August 2015 : 95% refund
Cancellation after 1st August 2015 : No refund.

If no refund is required but a change in participant registration is needed, then the Secretariat must be informed in writing via email to icjrsea@bloomcomm.com
  CONFERENCE SECRETARIAT
2nd INTERNATIONAL CONGRESS for JOINT RECONSTRUCTION – SOUTHEAST ASIA
c/o BLOOM COMMUNICATIONS
P1-2-1, Andalucia, Pantai Hill Park,
Jalan Pantai Permai, Bangsar South,
59200 Kuala Lumpur, Malaysia.
Tel : +603 2242 0902 / +6016 206 9610
Fax : +603 6207 6795
Email : secretariat@icjrsea.com
     
E. MOA AND APOA MEMBERSHIP
The registration price for MOA and APOA Members is only applicable if your MOA membership is still valid. If your membership detail is not filled in or is no longer current, your conference registration will automatically be processed as a South East Asia delegate or Overseas delegate.
 
To check your membership status, kindly contact your association’s secretariat at:-
  • Malaysian Orthopaedic Association (MOA) Secretariat
    Tel : +603 4025 1300
    Email : moa@moa-home.com

  • Asia Pacific Orthopaedic Association (APOA) Secretariat
    Tel : +603 4023 4700 / +603 4025 4700
    Email : admin@apoaonline.com